Nevada Medicaid

Nevada's Medicaid enrollment has grown by 83% since 2013

How to apply

Who is eligible

The aged, blind, and disabled. Also, coverage is available if your household income is up to 138% of poverty (about $16,105 for a single person). For pregnant women, income can be up to 160%, and children are eligible for CHIP with household income up to 200% of poverty.

Nevada expanded Medicaid in 2014 under the guidelines laid out in the ACA. As a result, roughly 266,000 people became newly eligible for coverage, most of them childless adults who are working but whose employers do not offer health insurance coverage.

Sharp increase in Nevada Medicaid enrollment

From the fall of 2013 through July 2016, total net enrollment in Nevada’s Medicaid program increased by 83 percent. This is a much higher percentage increase than most states, and is second only to Kentucky, where Medicaid enrollment has increased by 102 percent. Although people gain and lose eligibility for Medicaid throughout the year based on changing circumstances, the total Nevada medicaid enrollment in mid-2016 included an additional 276,875 people compared with late 2013.

Because Medicaid enrollment has increased so significantly in Nevada, there have been some concerns that newly-insured patients are finding it difficult to get timely appointments with healthcare providers.

Nevada’s uninsured rate also fell by nearly 40 percent from 2013 to 2015, going from 20.7 percent to 12.3 percent. The expanded access to Medicaid played a significant role in decreasing the uninsured population.

In addition to the newly-eligible population, enrollment has been growing among people who were already eligible for Medicaid but had not enrolled prior to the start of the 2014 open enrollment (open enrollment only applies to private plans; Medicaid enrollment is year-round, but the publicity surrounding open enrollment over the last few years has encouraged many Medicaid-eligible residents to seek coverage).

In 2012, roughly 88 percent of eligible children nationwide were enrolled in Medicaid or CHIP. In Nevada, that number was only 70.6 percent – among the lowest in the nation. But the expansion of Medicaid and the publicity surrounding the ACA has helped to bump up Nevada’s total Medicaid enrollment by more than three-quarters in under three years.

Am I eligible?

As of 2016, Medicaid in Nevada is available to the following legally-present residents:

Adults with household income up to 133 percent of poverty (138 percent with the 5 percent income disregard).

Pregnant women with household income up to 160 percent of poverty.

Children, depending on age, with household income up to 133 percent or 160 percent of poverty; all children are eligible for CHIP with income up to 200 percent of poverty.

How do I enroll?

You can enroll online through HealthCare.gov. Or you can enroll online through Access Nevada (run by the Nevada Department of Health and Human Services) If you have an existing Access Nevada account that you created before November 10, 2014, you’ll need to go back to the site and create a new account with a new username and password.

As of 2014, nearly 87 percent of Nevada Medicaid enrollees were covered under Medicaid managed care plans. In Clark and Washoe counties, the state operates a mandatory Medicaid managed care program called the Nevada Mandatory Health Maintenance Program, which has been in place since 1998. Health Plan of Nevada and AmeriGroup currently have the Medicaid MCO contracts for NMHMP, but the contracts expire in mid-2017, and the state is rebidding them in late 2016.

First Republican governor to accept Medicaid expansion

Nevada’s Governor Brian Sandoval announced in December 2012 that the state would expand Medicaid starting in 2014. Sandoval was the first Republican Governor to commit to expanding Medicaid. Originally, this was an integral part of the ACA, but the Supreme Court ruled in 2012 that expansion was optional, and 19 states had not moved forward with Medicaid expansion as of late 2016.

Sandoval cited the fact that the federal government would be paying the vast majority of the costs as a primary motivator for expanding coverage, and noted that although he’s generally opposed to the ACA, he believes Medicaid expansion is the correct path.

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